Prostate Cancer Misdiagnosis

Prostate cancer is the most common type of cancer in the United States, but it can often be treated successfully. About 87 percent of those diagnosed with prostate cancer are able to be cured or have the cancer go into remission. Over the past 40 years the survival rate for those diagnosed with prostate cancer has improved dramatically due to increased emphasis on screenings, awareness campaigns, and improved methods of treatment.

Diagnosing Prostate Cancer

There are two types of tests that are used to screen for prostate cancer, a digital rectal exam and a prostate-specific antigen test. During a digital rectal exam, a doctor inserts a gloved finger into the rectum to examine the prostate for abnormalities. A prostate-specific antigen test is a type of blood test that tests for prostate specific antigen, or PSA, in the blood. If either of these screen tests indicates an abnormality, a biopsy or ultrasound may be used to further verify the presence of prostate cancer.

During an ultrasound, a probe is inserted through the rectum to create pictures of the prostate using sound waves. During a biopsy, a thin needle is used to remove a small piece of tissue from the prostate. This tissue sample is then examined under a microscope for differences in the cell structure that may indicate cancer. If differences are found, they are gauged on a scale called the Gleason scale. The higher the degree of difference from healthy cell tissue, the more aggressive the cancer, in most cases.

Misdiagnosis of Prostate Cancer

Prostate cancer is often misdiagnosed or undiagnosed during a biopsy for several reasons. The prostate is a tiny gland, and cancerous cells may only inhabit a very small portion of that gland. During tissue removal, the surgeon may entirely miss the area of the prostate that contains cancerous cells. When the cells have been removed for examination, it is often difficult to interpret differences in the cell and whether they indicate cancer. It takes a highly skilled pathologist to spot and interpret the specific differences in prostate cell structure that signify cancer.

Prostate cancer is often misdiagnosed as bladder cancer. This is because an ultrasound may show lesions in the bladder, leading the physician to suspect bladder cancer. However, upon closer examination, these lesions are sometimes caused by cancer that has spread from the prostate. In these cases, a physician can discover whether the lesions are caused by bladder cancer or prostate cancer using a PSA test or by doing a biopsy, if the physician is educated on the possibility of misdiagnosis and knows to order further testing. Certain symptoms of elevated PSA levels, such as sleep disorders, may also alert physicians to the possibility of prostate cancer.

Dangers of Prostate Cancer Misdiagnosis

Misdiagnosis or delayed diagnosis of prostate cancer is always dangerous for the patient. If prostate cancer is diagnosed as bladder cancer, the physician may begin treating the patient for bladder cancer. Chemotherapy or radiation therapy may be targeted at the bladder, while allowing the prostate cancer to spread. This can also be harmful for cells that are not cancerous.

If a patient is diagnosed as having prostate cancer, surgery may be done in which the prostate is removed. If there is no cancer present, the patient will have undergone an unnecessary surgery, facing all of the possible complications that can happen during surgery. If the patient actually has another type of cancer, that cancer is also being allowed to spread while the patient is being treated for prostate cancer.

Delayed diagnosis of prostate cancer is dangerous because it lessens the chances of catching prostate cancer in early stages, when it is most treatable. The cancer may have spread past the point when surgery will be an effective option for treatment. It is much more difficult to remove cancer that is located in more than one area of the body, and treatment options are much more uncomfortable and less effective.